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Long-term visual and anatomical outcomes following anti-VEGF monotherapy for retinal angiomatous proliferation
Tarek S Hemeida1, Pearse A Keane, Laurie Dustin
1Doheny Eye Institute, Department of Ophthalmology, Keck School of Medicine of the University of Southern California, Los Angeles, CA 90033, USA.
Aim:
To study the long-term visual and anatomical outcomes of antivascular endothelial growth factor (VEGF) monotherapy for the treatment of patients with retinal angiomatous proliferation (RAP).
Methods:
Retrospective review of patients who were diagnosed as having AMD and RAP lesions, and who received anti-VEGF injections as the only mode of therapy.
Results:
20 eyes (15 patients; nine women, six men) with RAP lesions treated by anti-VEGF were encountered. The mean patient age was 85.8 years (SD+/-4.54). Nine eyes were treated with intravitreal ranibizumab alone, eight eyes were treated with bevacizumab alone, and three eyes received both drugs. At 1, 3 and 6 months' follow-up the median VA had improved from baseline (20/72) to 20/52 (range: 20/25 to 20/400), 20/45 (range 20/20 to 20/400), and 20/56 (range 20/20 to 20/400), respectively, (p>0.001, p=0.001 and p=0.05, respectively). At the 24-month follow-up, the improvement in VA, defined as a halving of the visual angle, occurred in 37.5% of the cases.
Conclusions:
Anti-VEGF monotherapy represents a useful treatment option for RAP, with stable or improved visual acuity in 62.5% of patients at 2 years. 25% of eyes required only a single injection, but in most cases (75%) repeated treatments were required, highlighting the need for long term follow-up. Although, in this small study, the results for visual improvement were not statistically significant beyond 3 months, our findings warrant further large-scale investigation.